Blank Check
Greetings!
I hope this message finds you well, easing gently into the holiday season. We have slid into the classic grey Ohio winter mode - moderate temps with plenty of clouds and varying degrees of rain. Thankfully things were dry and warm for yesterday's Candlelight Walking Tour. I'm not sure it has ever been so well-attended.
Three recent local restaurant experiences: The Birria Tacos at Pochos were delicious. The chocolate milk shake at Seven 4 Zero was yummy, and the Indian food at the Shan E Punjab Dhaba food truck is fantastic (if you commute via I-70, you can call your dinner order in and pick it up on the way home). All of these operators are wonderful additions to the local food scene.
This past Thursday I had both an endoscopy and colonoscopy. Ooh, gross, right? Yeah, whatever. Get over it. Both of my parents died of cancer. Anything I can do to prevent the Big C from getting the jump on me, I’ll do it. I have the pictures to prove it.
Over the summer I began experiencing some persistent heartburn symptoms, a first for me. Given my family history, it made sense to take a peak into my stomach to see what we might learn. This also synced up with the timing of my second colonoscopy. In terms of convenience, it made sense to do them both in the same session. To be clear, I feel fine and this was a pro-active attempt at screening for problems. If you are male, over the age of 50 and have not yet had colonoscopy - get off your ass and have it scoped!
The week of Thanksgiving, I received a call from an administrator at the facility where the procedures would take place. The purpose of her call was to let me know that I would be responsible for paying a portion of the facility fees. I asked her how much this would cost, and her answer was…fuzzy. She made it clear that she could only share the costs associated with using her facility - kind of like a room rental fee. But these costs would not include the amounts to be billed by the doctors, or possibly the laboratories that might need to analyze any tissue samples that arise out of the procedures. She also suggested that I call my insurer, to get more clarity on my financial obligations. She even gave me the diagnostic and procedural codes, info the insurance representative would likely need.
I won’t drag you into the minutia of the whole thing. It will suffice to say that I, a reasonably responsible and intelligent human being, after spending the better part of an hour on the phone, have absolutely no idea what I’m going to have to pay for these proactive, prevention-minded procedures. If I can’t get clarity regarding the costs of this relatively well-defined situation, how messy would it be if I were really ill, with fuzzier symptoms? Of course, we all know the answer - I would be screwed. So would you, probably. Yet we all just whistle through the graveyard, hoping circumstances don’t call for us to wrestle with this reality. And if we are in an actual health crisis, we'll just start the meter running and figure everything out later, right?
This 4-year old article from CNBC suggests that 2/3rds of all bankruptcies declared in the U.S. are due to people being buried by the costs of healthcare. It may not be fully accurate, but it has the ring of the truth to me. I saw a version of this play out with a friend many years ago when his wife was diagnosed with breast cancer. They pulled out all the stops fighting it, which pulled him away from work…the double-whammy of massive unplanned expenses and reduced income so that he could oversee her care did not drive him into bankruptcy, but it certainly could have. No doubt he is working harder today because of this massive life event.
Little old Neal can’t revise the entire U.S. healthcare system all by himself. But if I could, one feature of it would include a cost preview for patients - with dollar amounts and probabilities. If we can get an estimate of the cost to have maintenance work done our cars, we can get something similar for healthcare. Famed investor Charlie Munger passed away this past week at the tender age of 99. He is credited with the quote “Show me the incentives, and I’ll show you the outcome.” The incentives most here certainly are not aligned in favor of the consumers of health care - you and me. Our calcified system has rent-seekers charging fees at every turn, without adding value to the process of delivering care.
I believe that Lori and I have good insurance in place, but it certainly leaves open some range of financial doomsday scenarios. Unlikely scenarios, but not impossible. The market will gladly sell us more insurance, but I’m skeptical that we can fully eliminate all chances of being wiped out. There is no such thing as a risk-free life. We just have to manage the risks as best we can.
As humanity digitizes its information, we are able to see much more clearly so many disjointed patterns. The U.S. spends more per capita on healthcare than any other country, yet our life expectancy is less than that of many comparable countries. Obviously something is wrong. The only question is what should we do about it - but the institutions that benefit from the status quo will fight like hell to maintain it. I’m sure it’ll all get worked out in 50 or 100 years. Until then, don’t get sick.
Sunday Supper
Let your oven do all the work this Sunday - this sturdy roasted Oregano Chicken and roasted Asparagus w/ Crispy Leeks and Capers is a wonderful one-two punch.
Sunday Music
I stumbled across this artist recently - Gregory Porter is an incredibly soulful singer, songwriter and actor. Born in Bakersfield, California, his musical career took off after he moved to Brooklyn, New York in in 2004. This full concert in Basel, Switzerland was recorded a little more than a year ago. Enjoy!
Have a great week ahead! Offer support to others. Make good use of this day. And let me know how I can help.
Peace & Love,
Neal